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Articles 
John A. Heit, Catie E. Kobbervig, Andra H. James, Tanya M. Petterson, Kent R. Bailey, and L. Joseph Melton, III The incidence of venous thromboembolism during pregnancy has remained constant in the past 30 years. While the incidence of pulmonary embolism has been much higher in the postpartum period, it has decreased sharply in the past decade. Women younger than age 20 years and older than age 35 years are at greatest risk. The benefits and harms of prophylaxis with anticoagulants are not known in these patients.
Anna Wald, Andria G.M. Langenberg, Elizabeth Krantz, John M. Douglas, Jr, H. Hunter Handsfield, Richard P. DiCarlo, Adaora A. Adimora, Allen E. Izu, Rhoda Ashley Morrow, and Lawrence Corey The authors evaluated the relationship between condom use and acquisition of herpes simplex virus (HSV)-2 and HSV-1. In this observational study, consistent use of condoms was associated with lower rates of acquisition of HSV-2. Reducing the risk for HSV-2 acquisition is another reason for people at high risk for sexually transmitted disease to use condoms.
David B. Clifford, Scott Evans, Yijun Yang, Edward P. Acosta, Karl Goodkin, Karen Tashima, David Simpson, David Dorfman, Heather Ribaudo, Roy M. Gulick for the A5097s Study Team* Highly active antiretroviral therapy (HAART) regimens often include efavirenz. Physicians caring for HIV-infected patients have attributed adverse neuropsychological effects to efavirenz. In this substudy of a randomized trial, patients taking efavirenz had more neurologic symptoms during week 1 of treatment than patients taking placebo, but the rates were similar at weeks 4, 12, or 24.
Masahide Hamaguchi, Takao Kojima, Noriyuki Takeda, Takayuki Nakagawa, Hiroya Taniguchi, Kota Fujii, Tatsushi Omatsu, Tomoaki Nakajima, Hiroshi Sarui, Makoto Shimazaki, Takahiro Kato, Junichi Okuda, and Kazunori Ida The authors examined the role of the metabolic syndrome in the development of nonalcoholic fatty liver disease (NAFLD) in 4401 Japanese men and women. At baseline, 812 of participants had NAFLD. During follow-up, NAFLD developed in 10% of 3147 participants who were free of NAFLD at baseline. Having the metabolic syndrome at baseline was a strong predictor of developing NAFLD.
Improving Patient Care
Ira B. Wilson, Bruce E. Landon, Lisa R. Hirschhorn, Keith McInnes, Lin Ding, Peter V. Marsden, and Paul D. Cleary According to 8 quality-of-care measures assessed by medical record review, the quality of HIV care by nurse practitioners and physician assistants was similar to that provided by physician HIV care experts and was generally better than that provided by physicians who were not HIV care experts.
Updates
Peter H. Stone This Update covers the highlights of an extraordinary year in cardiology, including important research in the areas of unstable and stable coronary artery syndromes, risk factors for atherosclerotic disease, heart failure, cardiomyopathy, arrhythmias, peripheral vascular disease, and valvular heart disease.
Perspectives
Joshua E. Perry, Larry R. Churchill, and Howard S. Kirshner The conflicts and misunderstandings surrounding the plight of Terri Schiavo offer important lessons in medicine, law, and ethics. The authors review the current medical understanding of the persistent vegetative state, examine the legal history of the case, and review alternative ethical frameworks for thinking about the case.
Editorials
Richard V. Lee In this issue, Heit and colleagues provide solid clinical evidence to confirm current clinical wisdom: Pregnancy increases the risk for thromboembolism. No time during pregnancy is without thromboembolic risk.
Edward W. Hook, III In this issue, Wald and coworkers have further expanded the menu of proven measures for prevention of herpesvirus transmission, demonstrating that condoms protected men from genital herpes in a dose-dependent fashion. Strengths of the study include its multicenter design, the large number of carefully evaluated participants, and use of serologic measures for detection of infection.
Elizabeth E. Powell, Julie R. Jonsson, and Andrew D. Clouston In this issue, Hamaguchi and colleagues examined the relationship between the metabolic syndrome and nonalcoholic fatty liver disease (NAFLD) in healthy Japanese men and women drinking less than 20 g of ethanol per day. By identifying both prevalent and incident cases, the authors provide important new data on the rate of development or regression of NAFLD.
On Being a Doctor
Jaime E. Ollé-Goig The laboratory results suggest tuberculosis. I start Betty immediately on antituberculosis medications through a nasogastric tube and streptomycin injections. Three days later, her temperature has dropped and she has begun to talk in a lively manner. On the morning of the fifth day, Betty is no longer in her bed. The nurses think that she was probably taken away during the night.
Letters Preventing Sudden Cardiac Death
Advanced Lipoprotein Testing in Young Adults
Cost-Effectiveness in Hepatitis B
Outlier Status of U.S. Health Care Costs
The New York Case: Lessons Being Learned
Patient-to-Patient Transmission of Hepatitis C
Immune Thrombocytopenia Associated with Efalizumab Therapy for Psoriasis
Bradycardia and Edema in a Patient Receiving Herbal Therapy for Fertility
Sibutramine Use Associated with Reversible Hepatotoxicity
Athina Chounta, Sotirios Tsiodras, Spyros Zouridakis, Michalis Doumas, and Helen Giamarellou Correction: Single-Therapy Androgen Suppression in Men with Advanced Prostate Cancer: A Systematic Review and Meta-Analysis
Correction: Meeting Transfusion Safety Expectations
Laurence H. Baker, Daniel O'Connell, and Frederic W. Platt Because patients often have multiple symptoms, physicians must define an agenda for every medical encounter. Key tasks include discovering the patient's and the clinician's most urgent issues and deciding together which issues to address first.
John M. Byrne
Lisa B. Caruso and Ricardo Munarriz
Jennifer Fisher Wilson
D. A. Feinfeld
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